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J Verschakelen

Publications and source records attributed to J Verschakelen.

At least 37 records · Page 2Linked to original sources
PubMed1994

Value of computed tomography and mediastinoscopy in preoperative evaluation of mediastinal nodes in non-small cell lung cancer. A study of 569 patients.

The efficacy of computed tomography (CT) and mediastinoscopy as staging modalities to assess mediastinal lymph node status was evaluated in 569 patients with a presumed resectable non-small cell lung cancer (NSCLC). Computed tomography scan was performed in every patient and followed by mediastinoscopy in 331 and by thoracotomy in 477 patients. Mediastinal lymph nodes on CT larger than 1.5 cm were considered pathological. Overall, CT had a sensitivity of 69%, a specificity of 71% and an accuracy of 71% in identifying mediastinal lymph node metastases. For mediastinoscopy these figures were 72%, 100% and 89%, respectively. Computed tomography accuracy was distinctly lower in squamous cell carcinomas and in central tumors, as CT sensitivity was significantly lower in left-sided tumors. The positive predictive value (PPV) of CT in T1 lesions (29%) and PPV and negative predictive value (NPV) of CT in T2 squamous cell carcinomas (30% and 83%, respectively) were low, so questioning its use in those instances. We perform a mediastinoscopy in every situation except for squamous cell carcinomas or small (less than 3 cm) peripheral tumors in the absence of enlarged mediastinal lymph nodes. This selective attitude is rewarding since a) the number of pN2 in the straight thoracotomy group was only 16% versus 41% in the mediastinoscopy group, b) the exploratory thoracotomy rate in the straight thoracotomy group was low (4.6%).

Adenocarcinoma↗
PubMed1994

Pulmonary histiocytosis X diagnosed by bone biopsy. Report of a case.

Histiocytosis X of the lung is associated with bone lesions in 4 to 20%. We report a case in which the diagnosis was missed in spite of repeated bronchoscopies with transbronchial lavage. The diagnosis was finally established by isotope bone scan, subsequent skeletal CT-scan and bone biopsy.

Adult↗
PubMed1994

Lung function, CT-scan and X-ray in upper airway obstruction due to thyroid goitre.

The purpose of this study was to assess the clinical reliability and to compare routine lung function tests (maximal flows and resistance) and radiological images (computed tomography (CT)-scan and X-ray) in upper airway obstruction. We, therefore, performed these examinations prospectively in 28 female patients (aged 68 +/- 13 yrs) with a goitre and without pulmonary disorders. Lung function measurements consisted of maximum expiratory and inspiratory flow-volume curves and of airway resistance. CT-scans and X-rays were performed during apnoea at functional residual capacity (FRC). Peak expiratory flow was 3.6 +/- 1.3 l.s-1 (i.e. 62 +/- 21% predicted); airway resistance was 0.38 +/- 0.14 kPa (i.e. 149 +/- 58% pred); and specific conductance was 1.0 +/- 0.3 kPa (i.e. 70 +/- 24% pred). Almost all lung function tests were significantly correlated with each other. On CT-scan the tracheal cross-sectional area at the zone of tracheal narrowing could be evaluated in 26 patients and was 58 +/- 17% (CT1/2) of the control area 2 cm above the carina (CT2). On X-ray the sagittal and coronal tracheal diameters at the zone of narrowing could only be measured in 16 subjects and were 60 +/- 17% (X-dia1/2) of the diameter at the control level. CT1/2 and X-dia1/2 were significantly correlated to each other. No correlation was found between the lung function tests and the radiological indices except airway resistance and CT2. Routine lung function and CT-scan do not provide comparable information on the degree of airway obstruction due to a goitre.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Esophageal metastasis from breast carcinoma.

A case of esophageal metastasis from a breast carcinoma is presented. Location was, as usual, midesophageal. The interval of time between breast carcinoma and the onset of esophageal symptoms was rather long. Barium swallow examination enabled correct diagnosis, whereas several series of superficial endoscopical biopsies were negative. Diagnosis was confirmed by deep endoscopical biopsy.

Breast Neoplasms↗
PubMed1994

A persistent unilateral lung infiltrate.

We describe the case of an intrabronchial aspirated foreign body that caused a persistent right lower lobe infiltrate. A first fibreoptic bronchoscopy demonstrated a mass with tumour-like appearance in the right bronchus intermedias, but the bronchial biopsies and the cytological smears of the bronchial aspirate failed to reveal any malignancy. During a control fibreoptic bronchoscopy, we found a chicken bone in this friable granulation tissue. It was subsequently removed with a flexible bronchofibrescope and a four-pronged forceps under topical anaesthesia.

Aged↗
PubMed1993

Systemic to pulmonary artery shunting.

Two cases showing systemic to pulmonary artery shunting, during the venous phase of bronchial arteriography are presented. In the first patient with chronic bronchiectasis, the shunting is believed to be due to newly formed vessels in the granulomatous tissue. At pulmonary angiography, the increased pressure in the pulmonary arteries simulated an angiographic defect due to dilution of the contrast by retrograde opacification from a left to right shunt. In a second patient with proven pulmonary embolism a true defect was present at pulmonary angiography. Systemic to pulmonary artery shunting is believed to develop secondary to hypoxia.

Bronchial Arteries↗
PubMed1993

[A case of a limited from of Wegener's granulomatosis].

The history of a man who developed a limited angiitis and granulomatosis of the Wegener type is described. Wegener granulomatosis is a hypersensitivity disease (type III) with an unknown etiology. The typical radiological features, the differential diagnosis and treatment are briefly discussed.

Biopsy↗
PubMed1992

Pulmonary lymphangiomyomatosis.

We report a case of pulmonary lymphangiomyomatosis in a young female. CT--and especially high resolution CT--is more specific and sensitive than chest radiography in showing the lung abnormalities. Pathognomonic CT findings are the presence of thin walled cystic air spaces spread throughout the lung parenchyma without nodules and without regional predominance and mostly surrounded by normal parenchyma. The superposition of the multiple thin walls of the cysts is responsible for the reticular interstitial pattern observed at chest radiography.

Adult↗
PubMed1991

Occult tuberculous postpneumonectomy space empyema four years after lung resection.

We describe a patient in whom a tuberculous postpneumonectomy empyema developed 4 years after resection for lung cancer. The clinical presentation was dominated by non-specific constitutional symptoms, without any chest complaints. A computed tomographic scan of the chest suggested inflammation in the postpneumonectomy space. Ultimately Mycobacterium tuberculosis was cultured from material aspirated by needle thoracocentesis. To our knowledge this is the first report of a tuberculous postpneumonectomy empyema complicating resection for cancer.

Aged↗
PubMed1989

Soft tissue involvement, mediastinal pseudotumor, and venous thrombosis in pustulotic arthro-osteitis. A study of eight new cases.

A syndrome of hyperostosis of the thoracic wall, nonspecific signs of inflammatory disease, and palmar and plantar pustulosis is described in eight patients (Table 1). Seven had intersternocostoclavicular ossification, and one had chronic recurrent multifocal osteomyelitis. This complex of findings has been called "pustulotic arthro-osteitis". This report emphasizes the periosseous soft tissue inflammation and the unexplained subclavian and mediastinal vein thrombosis seen in two patients. Inflammatory periosseous and mediastinal lesions were seen on plain films in all eight patients and on computed tomographic (CT) scans in seven. Radiographs of the spine showed a spondyloarthropathy in three patients. This was characterized by ossification of the vertebral ligaments and sclerosis of the vertebral bodies. Awareness of the radiologic features of pustulotic arthro-osteitis is important because the clinical, biochemical and pathologic findings are often nonspecific and misleading.

Adult↗
PubMed1989

Pictorial essay. Roentgenologic appearance of traumatic diaphragmatic rupture.

The difficulties in recognizing a diaphragmatic rupture are well known and mostly due to a lack of typical clinical findings and an aspecific chest X-ray. This paper gives a brief review of the radiological techniques which can be helpful in the early diagnosis of traumatic rupture of the diaphragm.

Hernia, Diaphragmatic, Traumatic↗
PubMed1988

Preoperative CT examination for staging of mediastinal lymph-nodes in patients with (operable) non-small cell lung cancer.

In a prospective study of 100 and a retrospective study of 90 patients with non small cell lung cancer, the usefulness of CT in the preoperative staging of mediastinal lymph nodes was examined. The long-term prognostic value of CT was also investigated. Our results suggest that, using 1.5 cm as a criterion of size for malignancy, CT can be useful in the selection of patients for mediastinoscopy. CT can always help the surgeon in the mediastinal exploration but the long-term prognostic value is limited after the surgical-pathologic diagnosis has been made.

Carcinoma, Non-Small-Cell Lung↗
PubMed1988

Broncho-oesophageal fistula with vascular malformation.

We present a patient with a type III congenital broncho-oesophageal fistula and a connection between the systemic and the pulmonary circulation. The congenital fistula caused chronic bronchopulmonary suppuration with bronchiectasis which in turn was the cause of a left-to-right shunt, probably through multiple precapillary or capillary anastomoses.

Arterio-Arterial Fistula↗
PubMed1987

Adult linear IgA bullous dermatosis with bronchial involvement.

A 54-year-old man is described, suffering from adult linear IgA bullous dermatosis with involvement of the bronchial mucosa. The main respiratory symptoms were recurring haemoptysis, episodic narrowing of the airways and persistent non-specific bronchial hyperreactivity. On CT scan the trachea had a saber-sheath shape with tracheal ring calcification. Endoscopically the tracheo-bronchial mucosa was diffusely purpuric and hyperaemic and also showed pale elevated plaques, bullous lesions and ulceration. Histological examination of biopsies of skin and nasal and tracheo-bronchial mucosa showed subepithelial blister formation associated with an accumulation of polymorphonuclear cells at the epithelial-subepithelial junction, and linear IgA deposits on direct immunofluorescence.

Bronchi↗